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Pro Care Physiotherapy & Athletes' Injury Center
Fax: (613) 727-2977

Address: 460 West Hunt Club Rd, Unit 102A Ottawa, ON K2E 0B8

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Hand and Wrist Conditions

Hand and Wrist Explained

The wrist joint is composed of two bones in the forearm (Radius & Ulna) and eight small bones in the wrist (Carpals). The hand is a greatly complex part of the human anatomy.  It is composed of 27 bones including the ones in the wrist:

  • Carpals are the 8 bones in the wrist
  • Metacarpals are the 5 bones in the palm
  • Phalanges are the 14 small bones that form the fingers

Different joints are also found in the hand:

  • The knuckles are known as the MCP joints (Metacarpal-phalangeal  joint)
  • The joints in the fingers are known as the PIP and DID joints (Proximal interphalangeal joints and Distal interphalangeal joints)

Ligaments connect all the bones of the wrist and hand to provide stability.


Hand and Wrist Conditions

There are many possible injuries that can occur to the hand and wrist including:

  • Wrist / Hand Fracture
  • Wrist Sprain
  • Carpel Tunnel Syndrome
  • DeQuervain’s Tenosynovitis

 

Wrist / Hand Fracture

A Colles’ fracture is a “broken wrist”, where the distal part of the radius bone gets fractured. A Colles’ fracture is the most frequently broken bone in the arm. This injury usually happens when a person falls onto an outstretched arm or gets hit on the wrist.

People with osteoporosis or thinning of the bones are at high risk of fractures although it can happen to anyone that takes a fall or gets hit. After the fracture heals, intense physiotherapy is required to regain full motion and strength in the affected limb.

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Wrist Sprain

A wrist sprain occurs when the ligaments that connect the wrist bones to the hand bones stretch to far, usually during a fall on an outstretched arm.  The result can be small tears in the ligament, or even worse, a complete break in the ligament. Even though falls are the cause of a lot of wrist sprains, you can also get them by being hit on the wrist or by twisting it.

Wrist sprains are usually divided into 3 grades:

  • Grade 1: Pain with minor damage to the ligament
  • Grade 2: Pain with more severe damage to the ligament. A feeling of looseness to the joint and some loss of function.
  • Grade 3: Pain with a completely torn ligament. Severe looseness of the joint with loss of function.

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Carpel Tunnel Syndrome

Carpel tunnel syndrome causes pain, numbness, and tingling in the hand due to pressure on the median nerve in the wrist. The median nerve and several tendons cross to your hand through a small space in your wrist called the carpel tunnel. The pressure on the median nerve is due to swelling or anything that makes the carpel tunnel smaller, such as:

  • Illnesses (i.e. hypothyroidism, rheumatoid arthritis, diabetes)
  • Pregnancy
  • Obesity
  • Repetitive wrist movement
  • Wrist injuries
  • Bone spurs
  • Smoking (Blood flow to the median nerve is reduced)

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DeQuervain’s Tenosynovitis

DeQuervain’s tenosynovitis is an inflammation of tendons of the thumb. It causes pain along the back of the thumb and sometimes extending into the side of the wrist.

Thumb motion may be difficult and painful, especially when pinching, making a fist, or grasping objects.

DeQuervain’s tenosynovitis can be caused by a multitude of reasons, including:

  • Overuse
  • Direct blow to the thumb
  • Repetitive grasping
  • Rheumatoid arthritis
  • New mothers holding their newborn baby
  • Unknown cause

Some people find relief using a brace while treating the injury. Recovery times will vary depending on your age, general health, and how long the symptoms have been present. DeQuervain’s tenosynovitis is usually more resistant to treatment if the symptoms appeared more gradually. For these people, it may take longer to find relief.

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Can Physiotherapy Help?

Physiotherapists at Pro Care Physiotherapy & Athletes’ Injury Center can help with all hand and wrist conditions after performing a thorough assessment. The treatment may include:

  • Manual therapy to improve movement in your hand and wrist
  • Ultrasound, electrotherapy and/or acupuncture to relieve pain, swelling and promote tissue healing
  • An exercise program including strengthening and stretching to progressively return you to your daily and sporting activities
  • Suggest braces if needed for the injury
  • Massage to promote soft tissue healing and break up of scar tissue

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